The DSM Versus the Bible 


The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the official "bible" for identifying and categorizing mental disorders. The DSM provides lists of descriptions of thinking, feeling, or behaving that fit the various diagnostic categories. Psychiatrists and other mental health professionals then use these DSM categories to diagnose mental disorders.

Four medical doctors from the University of California, San Diego, used the DSM in their attempt to diagnose a person from the past, whom they had never met. In their article in the Archives of General Psychiatry (Vol. 58, Feb., 2001, p. 202) Eric Lewin Altschuler et al. consider whether Samson from the Bible (Judges 13-16) had Antisocial Personality Disorder (ASPD). They say, "The DSM-IV requires that 3 of the criteria be met for the diagnosis of ASPD. Samson meets 6." They list the 6 with the verses from Judges as proof:

"(1) Failure to conform to social norms with respect to lawful behavior" (ref. Judges 15:6; 16:1).

"(2) Deceitfulness, as indicated by repeated lying" (ref. Judges14:9).

"(3) Impulsivity" (ref. Judges 15:5).

"(4) Irritability and aggressiveness" (ref. his various physical fights).

"(5) Reckless disregard for safety of self or others" (ref. Judges 15:15; 16:17).

"(6) Lack of remorse" (ref. Judges 15:16).

These medical doctors contend that the ASPD started when Samson was quite young. However, they assure their readers that "Samson shows no evidence of schizophrenia" and that "Some of his behaviors . . . seem to have been done during a nonmanic state."

Consider this diagnosis of Samson in the context of diagnostic shifts. Homosexuality used to be listed as a mental disorder but was later changed to be a disorder only if the person felt uncomfortable about his condition. In considering the logic of this determining whether or not homosexuality is a mental disorder, Psychiatrist-lawyer Jonas Robitscher says, "The subject’s evaluation of his own condition thus became the criterion for inclusion in the disease or nondisease category" (Powers of Psychiatry, p. 175).

This is only one of a number of paradoxes in psychiatry. On the one hand, the psychiatric profession wants to be regarded as scientific in the classification of human behavior. On the other hand, they reveal the unscientific nature of their means of classification and diagnosis of disease by their labeling contradictions. They saddle Samson with a diagnostic label without so much as a diagnostic interview (as subjective as that is), even while permitting homosexuals to choose whether or not to be DSM labeled, according to how the homosexual feels about his condition.

Dr. Margaret Hagen, in her book Whores of the Court, describes the ubiquitous use of the DSM and how necessary it is to be able to bill and receive payments from third-party providers (p. 77).

The newest (1994) Diagnostic and Statistical Manual of Mental Disorders provides the civil litigant with literally hundreds of possible disorders, each neatly laid out with the necessary symptoms. It is hard to imagine that anyone could live in today’s society and not be diagnosed with at least one of these many disorders. After all, they include such exotic stuff as smoking cigarettes, having lousy sex, feeling rotten about your life or trapped in your job or marriage, and hating your body because you think you are too fat or too ugly. Anybody out there with low self-esteem?

If you are not Pollyanna-happy—and complain loudly about the fact that you are not—the odds are great that a psychoexpert can and will diagnose a mental problem for you.

Once society has accepted that the hundreds of ways people can be unhappy can all be labeled as specific mental disorders, then the diagnosis of those states of unhappiness, those disorders, becomes the special province of mental disorder experts (p. 250).

The most central scientific claim about the DSM is that it is a highly reliable system. This would mean that if the DSM guidelines were followed different psychiatrists would give the same label to a given person. In their book Making Us Crazy, DSM: The Psychiatric Bible and the Creation of Mental Disorders, Herb Kutchins and Stuart Kirk say the following about the claim of reliability for the DSM:

No study of DSM as a whole in a regular clinical setting has shown uniformly high reliability. And most studies, including the DSM field trials themselves, provide little evidence that reliability has markedly improved, much less been "solved" as a problem (p. 52).

Twenty years after the reliability problem became the central scientific focus of DSM, there is still not a single major study showing that DSM (any version) is routinely used with high reliability by regular mental health clinicians (bold added, p. 53).

The illusion that psychiatrists are in agreement when making diagnoses creates the appearance of a united professional consensus. In fact, there is considerable professional confusion. Serious confusion about distinguishing mental disorders from nondisordered conditions and the inability of clinicians to use the manual reliably make the development and use of DSM vulnerable to a host of nonscientific pressures. If well-trained and well-intentioned therapists often fail to agree on specific diagnoses, how can the incompetent or purposely deceptive diagnostician be identified? (p. 53).

Think about the fact that, compounding the absence of an agreed-upon definition for mental health, the most sophisticated system of classification of mental disorders (DSM) results in "well-trained and well-intentioned therapists" failing "to agree on specific diagnoses."

Altschuler and his colleagues labeled Samson ASPD according to an unreliable DSM system. In contrast, the Bible lists Samson as a man of faith (Hebrews 11:32). True believers will take the Word of God over the DSM worldly wisdom, about which we are warned in Scripture.

Now we will guess at a diagnosis for Altschuler et al., based upon a perfect, valid, and reliable "system" of diagnosis called the Bible. The Bible describes the fool: "The fool hath said in his heart, There is no God" (Psalm 14:1). Any fool, believing there is no God and that the Bible is not the very Word of God, can make any foolish and faulty diagnosis according to any worldly system.

PAL  V10N3 (May-June 2002)


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